Polycystic ovary syndrome (PCOS) symptoms tend to start gradually. Often, hormone changes that lead to PCOS start in the early teens, after the first menstrual period. Symptoms may be especially noticeable after a weight gain.

With PCOS, you may have only a few symptoms or many symptoms. It is common for PCOS symptoms to be mistaken for other medical problems.

Early symptoms

Early symptoms of PCOS include:

• Few or no menstrual periods. This can range from less than nine menstrual cycles in a year (more than 35 days between cycles) to no menstrual periods.³ Some women with PCOS have regular periods but are not ovulating every month. This means that their ovaries are not releasing an egg each month.
• Heavy, irregular vaginal bleeding. About 30% of women with PCOS have this symptom.⁴
• Hair loss from the scalp and hair growth (hirsutism) on the face, chest, back, stomach, thumbs, or toes. About 70% of women in the United States with PCOS complain of these hair problems caused by high androgen levels.⁵
• Acne and oily skin, caused by high androgen levels.
• Depression or mood swings. Hormonal changes are a known cause of emotional symptoms.

Living with PCOS symptoms can affect your sense of well-being, sexual satisfaction, and overall quality of life. This too can lead to depression.⁶ For more information, see the topic Depression or Depression in Children and Teens.

Gradual symptoms

PCOS symptoms that may develop gradually include:

• Weight gain or upper body obesity (more around the abdomen than the hips). This is linked to high androgen levels.⁵
• Male-pattern baldness or thinning hair (alopecia). This is linked to high androgen levels.
• Repeat miscarriages. The cause for this is not known. These miscarriages may be linked to high insulin levels, delayed ovulation, or other problems such as the quality of the egg or how the egg attaches to the uterus.
• Inability to become pregnant (infertility). This is because the ovaries are not releasing an egg (not ovulating).
• Symptoms of too much insulin (hyperinsulinemia) and insulin resistance, which can include upper body weight gain and skin changes, such as skin tags or dark, velvety skin patches under the arm, on the neck, or in the groin and genital area.
• Breathing problems while sleeping (obstructive sleep apnea). This is linked to both obesity and insulin resistance.³
• Pain in the lower abdomen and pelvis (chronic pelvic pain).

High blood pressure may be more common in women with PCOS, especially if they are very overweight. Your doctor will check your blood pressure.

The most common reasons that first bring women with PCOS to a doctor include:

• Menstrual problems.
• Male-type hair growth (hirsutism) on the face and body.
• Infertility.
• Weight gain or upper body obesity.